Vaccine Confidence Project [to 6 January 2018]

Confidence Commentary:Let Freedom Ring
Heidi Larson | 1 Jan, 2018
If there has been a theme over the past year, when it comes to public trust in vaccines, it has been the tension between individual freedoms and social cooperation, between choice and voice as an individual, or choice and voice in consideration of the broader community.

In an attempt to quell the spread of measles across Europe, reflecting gaps in vaccination and worn holes in the blanket of “herd immunity”, France, Italy and Germany announced various new vaccine ma-ndates and fines would be introduced. Germany and Italy enacted their new laws last year, while France’s new 11-vaccine mandate — up from 3 previously — went into effect from 1 January 2018. In India, Kerala State also issued a mandate for measles-rubella vaccination in the face of vaccine resistance and negative social media about the vaccination campaign. These moves, intended to arrest the spread of measles, triggered public protests, public anger and petitions against government decisions as imposing on freedoms.

In 2016, similar events occurred. In reaction to the Disneyland measles outbreak, California repealed its philosophical exemption option, while Australia instituted a “No Jab, No Pay” legislation which took day care benefits away from parents who did not vaccinate their children. Protests against these measures erupted in California and Australia, along with reactive protests standing up for the measures. Anger arose over claims that some of the laws – where school admittance was restricted to vaccinated children – impinged on their child’s right to education.

The growing challenge in the vaccine landscape is that it is no longer isolated individuals who are thinking twice or refusing vaccination, but that there are growing groups of people who are not only expressing their individual right to question and to choose, but are increasingly connected with others and demanding the right to choose as part of a larger movement. These movements are about principles of freedom and rights, not about specific vaccines, or specific safety concerns.

Standing up for rights to freedom of expression, to choice, and to respect and dignity are all healthy characteristics of democratic societies. But, contrarian views become problematic for a technology like a vaccine, whose success – at least for many vaccines – depends on “the herd”. The success of vaccination depends on the public accepting the voice of experts and government – both of whom are facing waning trust in many countries around the world.

Somehow the assumption that populations would accept – and continue to accept – more and more vaccines, just because they are good for personal and public health, needs a reality check. The ever-changing political, cultural and emotional lives of people have different notions of what is good for them, and we need to listen. This does not mean agreeing with misinformation about vaccines that is circulating on the internet and social media, but listening to the deeper, underlying sentiments – the feelings of alienation, the loss of personal contact and people’s sense of feeling “counted” rather than cared for.

When I was considering what to focus on for this New Year’s message, I looked back at history. One option was to write about the 100th anniversary of the 1918 Spanish Flu epidemic. But, I then remembered that 2018 marks 50 years since Martin Luther King was shot on his motel room balcony, killed for speaking out about freedom and civil rights.

I read through Dr King’s speech when he received the Nobel Peace prize in 1964, four years before his assassination. As my thought for 2018, I want to share a poignant quote from his speech:

Modern man has brought this whole world to an awe-inspiring threshold of the future. He has reached new and astonishing peaks of scientific success. He has produced machines that think and instruments that peer into the unfathomable ranges of interstellar space…This is a dazzling picture of modern man’s scientific and technological progress. Yet, in spite of these spectacular strides in science and technology, and still unlimited ones to come, something basic is missing. There is a sort of poverty of the spirit which stands in glaring contrast to our scientific and technological abundance. We have learned to fly the air like birds and swim the sea like fish, but we have not learned the simple art of living together.